Meanwhile Avery Comarow, the health-rankings editor for US News & Word Report, noted in a column: “

The data aren’t new, only updated. CMS had made the data available, if you hunted hard enough for it, for several years. I tracked it in my files.
But that’s just the point. Ordinary people haven’t hunted for it, and in fact didn’t even know it existed until news outlets like The Spokesman-Review in Spokane, WA, The Daily Show, and WPIX-TV in New York City told them.

The cluck-cluckers point out that patients don’t actually pay these wild charges. Nor do insurance companies that negotiate discounts that allow them to pay far less on their customers’ behalf. Comarow wrote: “Publishing the data won’t make those prices drop. Why would hospitals do that? Which means that the data won’t help consumers other than those who have to pay list price because they are uninsured and yet somehow can afford to shop around—and travel—so they can pay merely $50,000 or $100,000 out of pocket rather than double or triple that amount.”

The naysayers miss the point. The fact that the government stepped out of its cocoon and made the data public is a giant step in the move toward knowing what we pay for care and why. The problem is not that elites in the healthcare academy wrote about this a decade ago. The problem is the CMS data represents half a loaf.

Steve Brill got it about right. It’s true that most people know hospital care is costly, but as Brill demonstrated in his landmark “Bitter Pill” piece in Time earlier this year, most Americans don’t know why. Writing for Time’s blog, Swampland, last week, he suggested that the prices should be the starting point for reporters to ask their local hospitals to explain their pricing. Hard questions are in order.

Brill also zeroed in on another next step in the quest for healthcare transparency, a debate that could use more attention—the idea of making insurance companies disclose exactly what they pay hospitals and other providers for their services.

I would add a third step. Before patients really understand what they’re paying or companies have paid, they need uniform, standardized disclosures. The hodge-podge of Explanations of Benefits, or EOBs, we all receive do not help us understand pricing on the part of providers or insurance companies. There’s little clarity and no uniformity. Without that, comparisons are virtually impossible. Journalists could take a look at these EOBs and talk to all the people who scratch their heads at them, and maybe even crusade for clarity.

Meanwhile, bravo to the media outlets that covered the CMS story. Now they need to carry it further.


Follow @USProjectCJR for more posts from Trudy Lieberman and the rest of the United States Project team, including our work on healthcare issues and public health at The Second Opinion.


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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.